INTRODUCTIONThis study aimed to assess the frequency of anxiety and depression in a cohort of adult patients with atopic dermatitis (AD) in a tertiary dermatological centre, using the Hospital Anxiety and Depression Scale (HADS). We looked for any correlation between anxiety and depression with skin disease severity.

MATERIALS AND METHODSPatients with AD were recruited from the National Skin Centre, Singapore, from 2008 to 2009 for a prospective cross-sectional study. The scoring atopic dermatitis (SCORAD) grade was determined and the HADS was administered via interviews.

RESULTSA total of 100 patients (78 males, 22 females) were enrolled (92% Chinese, 4% Malays and 4% Indians). Their average age was 25.7 years. Sixty-five percent used topical steroids, 14% had previously taken oral prednisolone for the control of disease flares, and 20% were on concurrent systemic therapy. The mean SCORAD was 55.0, with 99% of patients having moderate or severe AD. The mean HADS anxiety score was 7.2 and the mean depression score was 5.0. The level of anxiety correlated well with that of depression (Spearman's rank correlation coefficient, ρ = 0.59,<0.05); 18% were considered as cases of anxiety and 5% as cases of depression. These patients also had higher SCORAD values compared to other patients with lower scores for anxiety or depression (<0.05). Linear regression demonstrated a statistically significant positive relationship between anxiety and depression scores, and SCORAD scores.

CONCLUSIONOur study identified, by means of the HADS, the frequency of anxiety and depression amongst a cohort of Singaporean patients with AD. More severe skin disease correlated to greater psychological burden. The HADS is a useful screening tool that can constitute part of the overall holistic management of patients with AD so as to improve patient care.

Adrenal Cortex Hormones ; therapeutic use ; Adult ; Anxiety ; epidemiology ; psychology ; Cohort Studies ; Comorbidity ; Cross-Sectional Studies ; Depression ; epidemiology ; psychology ; Dermatitis, Atopic ; drug therapy ; epidemiology ; psychology ; Female ; Humans ; Linear Models ; Male ; Prevalence ; Prospective Studies ; Singapore ; epidemiology ; Tertiary Care Centers

PURPOSE: The purpose of this study was to verify prevalence rates of atopic dermatitis (AD) in middle school students in Korea and to define AD and associated factors. METHODS: This study was conducted using secondary analysis of raw data from the 'The 6th Korean National Adolescent Health Behavior Survey, 2010' conducted by the Korea Centers for Disease Control. The participants were 37,570 students. General characteristics and health behavior-related characteristics were analyzed using descriptive statistics, chi2-test and logistic regression analysis. RESULTS: Results are as follows. 1. There were 8,494 middle school students (22.6%), who had been diagnosed with AD during the last 12 months. 2. Factors associated with AD in middle school students were gender (p<.001), grade level (p=.001), father's education (p<.001), mother's education (p=.032), regular dietary habits (breakfasts, p=.025; lunches; p=.003), stress (p<.001), recognition of subjective awareness of one's health conditions (p<.001), hand washing before meals at school (p=.013), and cessation education for both smoking (p=.002) and alcohol (p=.031). CONCLUSION: Results of the study indicate that in order to alleviate AD symptoms in these students, there is a need to develop nursing interventions and education programs taking into consideration these variables and verifying the effects of interventions and programs.
Adolescent ; Adolescent Behavior ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Dermatitis, Atopic/*epidemiology/psychology ; Female ; Health Behavior ; Humans ; Logistic Models ; Male ; Mental Health ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Smoking ; Students/*psychology